OUR SERVICES

obstetric scans

Viability/Dating Scan:

This scan is performed usually before 11 weeks to confirm the viability of the pregnancy, which is done by seeing the heart-beat of the baby. It also helps to date the pregnancy and to diagnose multiple pregnancies, if present.

Recent studies have shown that the length of the neck of the womb (Cervical length) might indicate the chances for going into labour prematurely. We will check this at the time of your 21 week scan or earlier if need be and then discuss the findings with you. In some women the doctor might want a cervical assessment earlier if there is any history to suggest miscarriages in the second trimester. This is specifically requested in women with the following history:

Routine Anomaly Scan

This is a detailed scan done between 19 – 22 weeks, to check the structures of the baby, ensure normal growth and normal placental position. We specifically look for normal structures in the baby’s brain, face, spine, heart, stomach, bowel, kidneys and limbs.

Sometimes it can be difficult to visualise all the structures. This tends to happen in larger women or when the fetal position is not favourable. In these situations, a second scan may be required to complete the assessment satisfactorily.

Fetal echocardiography consists of the assessment of baby’s heart before birth. Most children have a normal heart. Therefore, most heart scans prior to birth show no obvious abnormalities and the major heart structures can be identified as expected in a normal fetal heart.

Approximately 8 in 1,000 babies born alive will show a heart defect. Half of these are major defects that can be identified before babies are born if a specialised scan of the fetal heart is performed. Although most complex abnormalities are well tolerated by the baby while in utero, treatment is usually required after birth and maybe as early as in the first few days of life, often due to changes in the way the blood goes round following delivery.

For the minority of babies that show an obvious major abnormality, the nature of the defect and available management options will be discussed with the parents and follow up organised as appropriate.

Minor abnormalities such as small holes in the heart may also be detected, but they do not disturb the way the heart works, even after birth. Treatment is usually unnecessary for minor abnormalities, but follow up will be arranged as appropriate. Apart from structural defects, some babies will need to be assessed for rhythm disturbances as well. These will be assessed and treatment options discussed at the time of the consultation.

Fetal echocardiography is usually carried out between 20-23 weeks of gestation and a single scan is generally adequate to assess the fetal heart. However, in some situations, the fetal heart can be assessed as early as 13-14 weeks of gestation and provide a lot of information and reassurance to some parents who are at risk of having a child with a congenital heart defect. In these cases, a second fetal echo is scheduled later on in pregnancy.

This is also called a ‘fetal growth scan’ or a ’wellbeing scan’. This is usually done in the third trimester after 26 weeks of gestation.

During this scan we measure the baby's head, abdomen and limbs, and estimate the baby’s weight. This gives an idea about the growth of the baby. We also check the position of the baby in the womb, look at the baby’s movements, the amount of amniotic fluid, and the placental position.

We use Doppler ultrasound to check the blood flow in the umbilical cord and in the baby’s brain. In addition,we can also check to the blood flow the mother’s uterine arteries.

At our centers, we understand your excitement and joy as your pregnancy progresses. We offer you the opportunity to be reminded of this special time by keeping 3D/4D pictures and a DVD recording of the scan of your unborn baby as they develop and grow.

We are able to get a 3D or 4D picture only when the baby is positioned. We are able to get good pictures only if the baby’s position is favorable to satisfactory imaging.

Invasive TESTS

Invasive procedures are procedures designed to obtain samples from the placenta (CVS), amniotic fluid (amniocentesis) and fetal blood (cordocentesis) for analysis. They are offered to parents whose babies are thought to have an increased risk of having a chromosomal disorder such as Down syndrome (trisomy 21) or Edwards Syndrome (trisomy 18. It is also offered parents whose babies are at high risk for genetic disorders such as sickle cell, cystic fibrosis or thalassaemia.

The samples from the placenta, amniotic fluid and the fetal blood all have the same genetic makeup as the baby and hence are used in diagnosing these conditions. The sample is sent to the lab for the specified test. The initial result for the three chromosomal abnormalities comes back in three to five working days while the final full karyotype result takes about two weeks. Based on the indication and the scan findings, further detailed genetics testing can be done on the same sample. This will be discussed with you prior to the actual test. Although the majority of patients are fine after the test, there is a small risk of miscarriage 0.5% associated with these procedures.

Chorionic Villus Sampling

Chorionic villus sampling (CVS) is an invasive prenatal test, performed between 11 and 14 weeks of the pregnancy. Under ultrasound guidance, a fine needle inserted through the mother’s abdomen into the placenta and a small placental sample (chorionic villi) is collected.

Amniocentesis

Amniocentesis is an invasive prenatal test available after 15 weeks of pregnancy. Under ultrasound guidance, a fine needle is inserted through the mother’s abdomen into the amniotic sac and a sample of amnitic fluid is collected and sent to the lab.

Cordocentesis

Cordocentesis is an invasive test carried out from 18 weeks of pregnancy. Under ultrasound guidance, a needle is passed through the mother’s abdomen under ultrasound guidance and a sample of the baby’s blood is taken from the cord. In addition to the indications mentioned above, this test is of particular value in when the mother had rhesus negative blood group.

Non invasive test

neoBona - The new generation Non Invasive Prenatal Test – Certitude for you

neoBona test is an early and accurate test for Down syndrome (Trisomy 21), Edward Syndrome (Trisomy 18), and Patau Syndrome (Trisomy 13). The test can also evaluate fetal sex and sex chromosome (X, Y) conditions.

neoBona is accurate with a sensitivity greater than 99.9% for Down’s and Patau Syndromes. neoBona is a simple test as it only requires a single blood test from the mother hence, safe for the fetus. The turn-around time is 5 days after the sample is received at the laboratory.

It can be performed for women with pregnancies of at least 10 weeks’ gestational age. It is available for any singleton or twin pregnancy, including all those conceived by IVF.

To discuss more about the values and advantages of the test, please feel free to contact us and we will assist you in order to make an informative decision.

Genetic Counseling

We provide genetic counseling, which is a critical service to individuals and families considering genetic testing. This counseling would help them to identify their risks for certain disorders, investigate their family history and interpret information to determine if testing is needed.

Prenatal Services

Genetic counseling would help couples when

They have an increased risk for chromosomal abnormalities. This may be from a screening test or family history and the counselor will discuss their risks and the option of further screening tests or a diagnostic test.

A fetal abnormalityis identified on ultrasound scan. The genetic counselor will provide information onappropriate genetic testing options either during the pregnancy or in the post-natal period.

A family is at risk for a fetal abnormality.

Prenatal noninvasive testing (NIPT) or invasive testing (CVS/amniocentesis) is offered or requested. The genetic counselor will discuss the benefits and implications of testing and help the couple make a decision that is appropriate for them as a family.

Prenatal diagnosis of a known familial genetic condition is requested. The genetic counselor will liaise with international laboratories to provide up to date appropriate test options.

There is a concern about exposure to drugs, medication, chemicals or radiation that might cause congenital conditions. The genetic counselor will explain the risks using up to date medical literature

Preconception genetic counseling

Pre conception genetic counseling is offered to couples who are married or will likely marry within the family to discuss risks of inherited conditions and the option of genetic carrier screening tests.

It is also helpful for couples to optimise their health status before pregnancy and this is especially applicable if either of the couple have a medical condition and / or on any medication.

General genetic counseling

In addition to the above services, we also provide genetic counseling to explain genetic test results or a genetic diagnosis and the risks of inheritanceto an individual, couple and their family. This service is also applicable when a child has been given agenetic diagnosis by a geneticist or paediatrician. The counsellor can guide the parents when a diagnostic genetic test is requested by discussing available options for the affected child and also for the extended family.

Genetic counseling and testing for adult conditions and cancer susceptibility genes are provided after assessment of the Medical reports and the family history.

Gynaecological Services

We have an experienced team of Physicians, who have specialized in Gynaecology.

Pelvic Scan

This is a part of a regular check-up for every woman. This scan can be performed abdominally or transvaginally to check the uterus, endometrium (lining of the uterus), cervix, fallopian tubes and ovaries. It is usually carried out as a diagnostic test in the following situations:

Lower abdominal pain

Suspected Pelvic masses (such as fibroids, ovarian cysts)

Location of IUD's (intra uterine device)

Irregular menstrual bleeding

Post-menopausal bleeding- for assessment of the endometrium.

Infertility

Suspected polycystic ovaries.

Ovarian cancer screening

Tubal Patency Check

This is a special test designed to assess the patency of the fallopian tubes. It combines the latest ultrasound technology with a contrast study using a water based (foamy gel) contrast media. This eliminates the risk of allergic reactions and causes minimal discomfort, when compared to the dye used in a standard hysterosalpingogram. It also allows us to assess the integrity of the lining of the uterus and eliminates exposure to X-ray radiation that may be harmful to the reproductive organs.

It is recommended that this examination is carried out in the first half of the menstrual cycle to avoid any disturbance of a possible pregnancy. It is performed in the clinic by experienced physicians and does not require any form of anaesthesia. Although it is usually pain free, some women may experience period like discomfort during or after the examination.

Diagnosis of infertility

Couples who are experiencing difficulties with conceiving have several testing options available to them, which can identify the problem. We at the FGMC can test the semen count of the male partner, test the hormone levels for the female partner as well as conduct further investigations through ultrasound (Tubal Patency Check).

PREGNANCY RELATED SKIN DISORDERS

Common skin conditions during pregnancy generally can be separated into three categories: hormone-related, preexisting, and pregnancy-specific.

During pregnancy, the surge in hormones also affects the skin. In our center, our Dermatologist will attend to common skin conditions linked to pregnancy such as hyperpigmentation, melasma (also known chloasma), pruritic urticarial papules and plaques of pregnancy (PUPPP), stretch marks, skin tags, acne, psoriasis, atopic dermatitis among others.

Stretch marks occur in up to 90 percent of pregnant women by the third trimester. They appear a pink-purple lines or bands on the abdomen, buttocks breasts, thighs or arms. The cause of stretch marks includes physical (actual stretching of the skin) and hormonal factor.

Hyperpigmentation is experienced by many women. It is the appearance of dark spots or on the skin. This is caused by an increase in naturally occurring melanin during pregnancy. Naturally, these hyperpigmented areas will resolve after delivery, however, oftentimes, it can continue for years.

An increase or decrease in growth and production of hair is common. Due to endocrine changes during pregnancy, many experience excessive growth of hair on the face but is resolved postpartum. Nails usually grow faster during pregnancy. Pregnant women may also experience increased brittleness of nails.

Pre-existing skin conditions like atopic dermatitis; psoriasis; fungal infections and fibromas may change during pregnancy. There are chances that they may become better or some may worsen during pregnancy.

One most common skin disorder during pregnancy is PUPPP (pruritic urticarial papules and plaques of pregnancy). They appear on the abdomen during the third trimester together with stretch marks. Women who are on their first pregnancy, having twins or has familial occurrences are most likely to experience PUPPP.

Dr. Shanthi Sairam is very professional, full of patience and warm hearted. Great center.

MJ Al Serkal( Patient Testimonial )

Dr. Afshin is the best and #1 in the Middle East. Apart from being professional, his behavior as a doctor is excellent. Excellent nurses and professional. If I could be pregnant again, I will come back to him. My husband and I are both very satisfied of the services provided

Mrs. Susan Ebrahimi( Patient Testimonial )

Thank you so much for the good news Kathleen. We are so happy and thankful. Thanks to God. Thanks to you, to Dr. Afshin and to your staffs for all your support. God Bless us

Caryl & Alfie( Patient Testimonial )

Kathleen, thank you very much for you call and the report.
It was very nice meeting with you, and good advice. And now this reports makes us happy and satisfied. Thank you all @ Fetal Center. God bless you.

Mr. Ali & Mrs. Kausar( Patient Testimonial )

Dr. Shanthi Sairam is very professional, full of patience and warm hearted. Great center.